摘要
目的 分析肺结核患者血清γ干扰素诱导蛋白10(IP-10)、细胞因子信号转导抑制物1(SOCS1)及糖类抗原125(CA125)表达意义及其与引发支气管狭窄的相关性.方法 回顾性选择2021年1月至2023年1月河北省胸科医院收治的116例肺结核患者作为观察组,同期116名健康体检者作为对照组.根据观察组患者胸部影像学检查结果,分为重度组(n=26)和轻中度组(n=90);通过纤维支气管镜检查及活检,判断患者是否存在支气管狭窄,分为支气管狭窄组(n=42)与单纯肺结核组(n=74).检测所有入选者血清IP-10、SOCS1及CA125水平,比较血清IP-10、SOCS1及CA125在对照组与观察组、不同严重程度的肺结核患者中的差异性;比较支气管狭窄组与单纯肺结核组第1秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气峰流速(PEF);分析血清IP-10、SOCS1及CA125与肺结核患者肺功能相关指标及其并发支气管狭窄的相关性.采用受试者工作特征(ROC)曲线分析血清IP-10、SOCS1及CA125水平预测肺结核患者发生支气管狭窄的效能.结果 观察组血清IP-10、CA125水平分别为(95.84±12.58)ng/L、(1.89± 0.86)U/mL,均高于对照组[(71.25±5.63)ng/L、(0.74±0.23)U/mL],SOCS1 水平为(165.32±7.95)μg/L,低于对照组[(252.54±24.71)μg/L],差异均有统计学意义(P＜0.05).重度组肺结核患者血清IP-10、CA125水平分别为(106.74±15.01)ng/L、(2.67±1.12)U/mL,均高于轻中度组[(89.72±8.16)ng/L、(1.45±0.60)U/mL],SOCS1 水平为(154.12±6.07)μg/L,低于轻中度组[(200.75±15.83)µg/L],差异均有统计学意义(P＜0.05).支气管狭窄组FEV1、FVC、PEF均小于单纯肺结核组,差异均有统计学意义(P＜0.05).经Pearson相关性分析,肺结核患者FEV1、FVC、PEF与血清IP-10、CA125水平呈正相关(P＜0.05),与SOCS1水平呈负相关(P＜0.05).经ROC曲线分析,血清IP-10、SOCS1联合CA125预测肺结核患者发生支气管狭窄的敏感度为89.12％,特异度为48.63％,曲线下面积为0.924.结论 肺结核患者血清IP-10、CA125水平明显升高,SOCS1水平降低,与病情严重程度相关,其联合预测支气管狭窄具有较好的效能.
Abstract
Objective To analyze the expression significance of serum gamma interferon-inducable protein 10(IP-10),suppressors of cytokine signaling 1(SOCS1)and carbohydrate antigen 125(CA125)in patients with pulmonary tuberculosis and their correlation with bronchial stenosis.Methods A total of 116 patients with pulmonary tuberculosis admitted to Hebei Provincial Chest Hospital from January 2021 to January 2023 were retrospectively selected as the observation group,and 116 healthy subjects in the same period were selected as the control group.Ac-cording to the chest imaging examination results of the observation group patients,they were divided into the severe group(n=26)and the mild to moderate group(n=90);through fiberoptic bronchoscopy and biopsy,the patient was determined to have no bronchial stenosis and was divid-ed into the bronchial stenosis group(n=42)and the simple pulmonary tuberculosis group(n=74).The expression levels of serum IP-10,SOCS1 and CA125 in all the participants were detected,and the differences of serum IP-10,SOCS1 and CA125 in the control group and the ob-servation group and in patients with pulmonary tuberculosis of different severity were compared.The first second forced expiratory volume(FEV1),forced vital capacity(FVC),and peak expiratory flow rate(PEF)were compared between the bronchial stenosis group and the simple pulmonary tuberculosis group.The correlation of serum IP-10,SOCS1 and CA125 with pulmonary function and bronchial stenosis was analyzed.The efficacy of predicting bronchial stenosis in patients with pulmonary tuberculosis using levels of serum IP-10,SOCS1,and CA1 25 was evalua-ted using receiver operating characteristic(ROC)curves.Results The levels of serum IP-10 and CA125 in the observation group were(95.84 ±12.58)ng/L and(1.89±0.86)U/mL,respectively,which were higher than those in the control group[(71.25±5.63)ng/L and(0.74 ±0.23)U/mL],the level of SOCS1 was(165.32±7.95)μg/L,which was lower than that of the control group[(252.54±24.71)μg/L],the differences were statistically significant(P＜0.05).The levels of serum IP-10 and CA125 in the severe group of pulmonary tuberculosis pa-tients were(106.74±15.01)ng/L and(2.67±1.12)U/mL,respectively,which were higher than those in the mild to moderate group[(89.72 ±8.16)ng/L and(1.45±0.60)U/mL],the level of SOCS1 was(154.12±6.07)μg/L,which was lower than that in the mild to moderate group[(200.75±15.83)μg/L],the differences were statistically significant(P＜0.05).The FEV1,FVC,and PEF of the bronchial stenosis group were all lower than those of the simple pulmonary tuberculosis group,and the differences were statistically significant(P＜0.05).Accord-ing to Pearson correlation analysis,the FEV1,FVC and PEF were positively correlated with serum IP-10 and CA125 levels(P＜0.05),and negatively correlated with SOCS1 levels(P＜0.05).According to ROC curve analysis,the sensitivity,specificity and AUC of serum IP-10 and SOCS1 combined with CA125 in predicting bronchial stenosis in patients with pulmonary tuberculosis were 89.12％,48.63％and 0.924,respec-tively.Conclusion The levels of serum IP-10,CA125 in tuberculosis patients significantly increase,and the SOCS 1 level decreases,which were correlated with disease severity,and their combination has a good efficacy in predicting bronchial stenosis.
维普
万方数据